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[Abdominal tumor after persistent coughing and uncontrolled anticoagulation].
K Wandeler-Meyer1, J Bremerich, M Christ
1Medizinische Klinik, Universitätsspital Basel. WandelerK@uhbs.ch
Praxis
|January 7, 2010
Summary
An 83-year-old woman developed a rectus sheath hematoma after experiencing cough attacks while on antiplatelet and anticoagulant therapy for myocardial infarction. This case highlights a rare complication of these common cardiovascular treatments.
Area of Science:
- Cardiology
- Gastroenterology
- Radiology
Background:
- ST elevation myocardial infarction (STEMI) requires antiplatelet and anticoagulant therapy.
- Rectus sheath hematoma is a rare but serious complication, often associated with anticoagulation.
- Coughing can increase intra-abdominal pressure, potentially precipitating hematoma formation.
Observation:
- An 83-year-old female patient with STEMI presented with left lower abdominal pain and a palpable mass.
- The patient was undergoing treatment with antiplatelet medication and systemic anticoagulants.
- The symptoms developed following severe cough attacks.
Findings:
- Abdominal sonography and computed tomography confirmed a rectus sheath hematoma.
- The hematoma was associated with anemia, likely due to blood loss.
- The clinical presentation and diagnostic imaging were consistent with this diagnosis.
Implications:
- This case underscores the importance of considering rectus sheath hematoma in patients on anticoagulation presenting with abdominal pain.
- Early diagnosis through imaging is crucial for appropriate management.
- Further research into risk factors and preventative strategies for rectus sheath hematoma in this patient population is warranted.
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